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    Form Visitor Very High Priority Maret 23

    Uploaded by

    aldy.anugrah.ardana
    The document is a visitor form for a surveyor visiting PT. SCCI. It contains information such as the visitor's name, ID number, position, emergency contact, dates of visit, transportation and accommodation details, required safety equipment, and approval signatures.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Form Visitor Very High Priority Maret 23

    Uploaded by

    aldy.anugrah.ardana
    5 views1 page
    The document is a visitor form for a surveyor visiting PT. SCCI. It contains information such as the visitor's name, ID number, position, emergency contact, dates of visit, transportation and accommodation details, required safety equipment, and approval signatures.

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    Form Visitor Very High Priority maret 23

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    © © All Rights Reserved

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    The document is a visitor form for a surveyor visiting PT. SCCI. It contains information such as the visitor's name, ID number, position, emergency contact, dates of visit, transportation and accommodation details, required safety equipment, and approval signatures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    5 views1 page

    Form Visitor Very High Priority Maret 23

    Uploaded by

    aldy.anugrah.ardana
    The document is a visitor form for a surveyor visiting PT. SCCI. It contains information such as the visitor's name, ID number, position, emergency contact, dates of visit, transportation and accommodation details, required safety equipment, and approval signatures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    FORM VISITOR VERY HIGH PRIORITY

    ID Number / Blood
    No Full Position / Level Company & Full Address Emergency Contact
    Name Passport *) Type
    1. Prasetia Dwi Putra 6205052812900003 Surveyor PT. SCCI O 085246200462

    *) Attach Letter of Assignment, Employee ID Card, Copy ID Card and/or Passport

    Responsible Department : CQC Time Visit : 20 Maret 2023 To Finish To Finish


    Company : PT. SCCI Purpose of Visiting : Kegiatan Stock Opname
    User / PJO : Aldy Ardana Anugrah

    GENERAL AFFAIR HSE

    Land Transportation Request Induction Date : ………………….


    for
    Date To
    Date To Safety Equipment :
    Date To Safety Shoes, No ………………….
    Airlines Reservations Itinerary Safety Helmet
    Date Fr To Reflector Vest
    Date Fr To Life Vest
    Accommodation Form Riwayat Perjalanan
    Date To Mess Num …………………. Hasil dan Kesimpulan Pemeriksaan Kesehatan
    Date To Hotel
    Remarks Remarks

    Note : Requested by, Approved by, Approved by, Approved by


    1. Put checkmark in the column selected.
    2. Give an explanation on the remarks
    column.
    3. At latest 5 working days before
    visitor arrives, GA has received
    complete form.
    4. Kategori : tenaga medis, dan aparat
    yang bertugas pada kondisi
    kedaruratan; Compliance person;
    Pengapalan batubara dan un-loading
    material LPB, pengangkutan LB3 dan Name : Aldy Anugrah Ardana Name : Darmansach Name : Saiful Amar Name: Arif Budiman
    bahan peledak, serta pengantaran
    kebutuhan logistik User / PJO Responsible Department MUTU HSE MUTU Pjs. KTT MUTU

    MUTU-GA-FM-002 Rev. 04, 04-04-2020

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